Healthcare in Dorset

Healthcare in Dorset is now the responsibility of Dorset Clinical Commissioning Group. Dorset County Council is leading in the development of an electronic health record, to be called the Dorset Care Record, provided by Orion Health. It is intended to enable all health and social care providers to share records.[1]

History

From 1947 to 1965 NHS services in Dorset were managed partly by South-West Metropolitan Regional Hospital Board and partly by the South-Western Board, which was responsible for the Lyme Regis area. In 1965 a new Board was formed for Wessex which also covered Dorset apart from Lyme Regis. In 1974 the Boards were abolished and replaced by Regional Health Authorities. The whole of Dorset came under the Wessex RHA. Regions were reorganised in 1996 and Dorset came under the South and West Regional Health Authority. Dorset had an Area Health Authority from 1974 until 1982 when it was divided into two District Authorities for East and West Dorset which were amalgamated in 1992. Regional Health Authorities were reorganised and renamed Strategic Health Authorities in 2002. Dorset was part of Dorset and Somerset SHA. In 2006 regions were again reorganised and Dorset came under NHS South West until that was abolished in 2013. There were two Primary Care Trusts for the area: Bournemouth & Poole Teaching PCT and Dorset PCT.

Sustainability and transformation plans

Dorset formed a sustainability and transformation plan area in March 2016 with Tim Goodson, the Chief Officer of Dorset Clinical Commissioning Group as its leader.[2] It is facing a shortfall of £229 million in 2020. It was the first area to start formal consultation.

The main proposal is for the centralisation of emergency hospital services in Bournemouth and the establishment of a single cancer service and a single cardiac service for the county. Poole hospital would become a Major Planned Care Hospital with fewer beds. The 13 community hospitals will be reduced to seven 'community hubs' with beds and a further five 'community hubs' without beds. The community hospitals at Alderney, Westhaven and St Leonards would close. The community hubs would permit outpatient appointments outside of acute hospitals. The plan hopes to deliver a 25% reduction in unplanned medical admissions and 20% reduction in unplanned surgical admissions.[3] That would mean 100,000 patients a year treated closer to home rather than in hospital. A corresponding reduction in the number of GP practices is anticipated. [4]

Primary care

There are 98 GP practices, operating at 135 sites, in the county.[5] Out-of-hours services are provided by South Western Ambulance Service NHS Foundation Trust.

A private GP service was established at Poole Road Medical Centre in Bournemouth in 2017 where patients can pay to skip waiting lists to see a doctor.[6]

Healthwatch

Healthwatch Dorset, an organisation set up under the Health and Social Care Act 2012 to act as a voice for patients, organised mystery shopping in Spring 2014, visiting every practice to see how easy it was to make a complaint. Their report was generally favourable.[7] It has over 250 volunteers, and won the 'Making a Difference through Volunteering' Award in the national 'Healthwatch Network Awards of Achievement 2015, which had 150 entries.[8]

Public health

In 2012 public health responsibilities were transferred away for the NHS to local authorities. Public Health Dorset was established as a partnership of Bournemouth Borough Council, Poole Borough Council, and Dorset County Council.

Relations between providers

In 2011 Dorset County Hospital NHS Foundation Trust stopped providing services in community hospitals operated by Dorset HealthCare University NHS Foundation Trust. They had run outpatient clinics, surgery and radiology in six of the hospitals run by the community and mental health provider but said they would save £2.5 million a year by doing so. This was in response to a 3% reduction in activity commissioned by NHS Dorset.[9]

Acute services

The main hospital providers are Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust, Dorset County Hospital NHS Foundation Trust and Poole Hospital NHS Foundation Trust.

Proposals to merger Poole Hospital NHS Foundation Trust with Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust in order to save money were blocked by the Competition Commission in 2013. Both trusts said they were "deeply disappointed" and felt the merger was the best option to ensure "high-quality hospital services to local people".[10]

The Clinical Commissioning Group launched a major review into the way healthcare is provided across the county in October 2014. They are spending £2.75 million on the review and have hired a consortium of consultants, headed by McKinsey & Company. The Dorset Health Campaign has slammed the cost of the review and the appointment of the consultants, and has said it fears there will be increased privatisation in the service in Dorset following the review. The CCG says it does not have the specialist skills, experience, capacity and expertise to deliver a major Clinical Services Review of this kind and that the cost is less than 0.3 per cent of the annual budget of the CCG.[11]

Plans to develop a major emergency hospital with 24-hour access to consultants will be developed at Royal Bournemouth Hospital. Poole Hospital will be come the centre for planned care according to plans agreed by the CCG in May 2015.[12] The merger between Bournemouth and Poole was proposed again in 2016 because "the many benefits associated with these changes could be achieved more easily under one management structure.”[13]

Community Care

Macmillan Caring Locally is based in Dorset, supporting cancer patients in the county. Dorset HealthCare University NHS Foundation Trust is responsible for all community and mental health services across the county.

Palliative care is provided by Forest Holme Hospice and the Lewis-Manning Hospice in Poole, Weldmar Hospicecare Trust in Dorchester, and Julia's House in Bournemouth.

Millbrook Healthcare runs the wheelchair service in West Dorset.

See also

References

  1. ↑ "All you need to know about the new £7m electronic record sharing system for patients in Dorset". Bournemouth Echo. 16 April 2017. Retrieved 17 April 2017.
  2. ↑ "The leaders chosen for 41 of England's STPs". Health Service Journal. 30 March 2016. Retrieved 18 April 2016.
  3. ↑ "‘Major changes’ proposed in first formal STP consultation in the country". National Health Executive. 5 December 2016. Retrieved 17 April 2017.
  4. ↑ "Sustainability and Transformation Plans: Find out about your STP". NHS Support Federation. March 2017. Retrieved 30 March 2017.
  5. ↑ "Councils reject NHS plans due to lack of GP investment". Pulse. 30 November 2016. Retrieved 2 December 2016.
  6. ↑ "NHS GP practice sets up a private service - by paying up to £145 to jump the queue". Southern Daily Echo. 6 February 2017. Retrieved 14 July 2017.
  7. ↑ "Dorset GP surgeries ‘mystery shopped’ over complaints procedure". Bournemouth Echo. 4 June 2014. Retrieved 14 December 2014.
  8. ↑ "Dorset Healthwatch wins national award". Western Gazette. 6 July 2015. Retrieved 6 July 2015.
  9. ↑ "Dorset County Hospitals to cut services in the community". Health Service Journal. 21 December 2011. Retrieved 17 November 2014.
  10. ↑ "Dorset hospital trusts merger plan blocked". BBC News. 13 October 2013. Retrieved 17 November 2014.
  11. ↑ "Health chiefs set to spend £2.75million on review into saving money in NHS". Dorset Echo. 15 November 2014. Retrieved 17 November 2014.
  12. ↑ "Bournemouth is CCG's preferred choice for emergency centre". Health Service Journal. 12 May 2016. Retrieved 31 July 2016.
  13. ↑ "Bournemouth and Poole reopen talks on blocked merger". 8 September 2016. Retrieved 3 November 2016.
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